Individual provider Active NPI

Abdulrahman Khaledy Sultan, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1679682652
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A62946 Issued in CA
Practice address
11706 Darlington Ave Apt 202
Los Angeles, CA 90049-5517
Phone
(310) 613-5566
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A62946 CA Primary

Addresses

Primary practice location

11706 Darlington Ave Apt 202
Los Angeles, CA 90049-5517

Mailing address

11706 Darlington Ave Apt 202
Los Angeles, CA 90049-5517
Phone (310) 613-5566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204001241 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7618872391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
El Proyecto del Barrio, Inc. CurrentSince Sep 2, 2017 Accepting new patients
El Proyecto del Barrio, Inc. Current Accepting new patients
El Proyecto del Barrio, Inc. CurrentSince Sep 2, 2017 Accepting new patients
Optumcare Management, LLC Past Accepting new patients
SC Medical, Inc. Past Accepting new patients
SC Medical, Inc. PastSince Mar 4, 2021 Accepting new patients
Providence Facey Medical Foundation Internal Medicine Past Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients

Locations

8902 Woodman Ave
Arleta, CA 91331
Phone (818) 830-7033

18250 Roscoe Blvd
#200
Northridge, CA 91325
Phone (818) 721-4800

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1679682652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11706 DARLINGTON AVE APT 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495517",
            "telephone_number": "310-613-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11706 DARLINGTON AVE APT 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495517",
            "telephone_number": "310-613-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALEDY SULTAN",
        "first_name": "ABDULRAHMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.